MRI of nasopharyngeal carcinoma metastatic to the cerebellopontine angle

Abstract

In patients with nasopharyngeal carcinoma, intracranial spread may occur via direct extension from the base of the skull or via perineural spread. Perineural spread usually affects branches of the trigeminal nerve. We describe two patients with recurrent nasopharyngeal carcinoma, who presented with a solitary mass in the cerebellopontine angle without associated bony destruction. MRI findings mimicked those of acoustic schwannoma. The imaging findings and possible pathways of spread are discussed.

Ear-Related Issues in Patients with Nasopharyngeal Carcinoma

“…In these patients, recurrent or persistent NPC involving the CPA, temporal bone, or parotid should be excluded (Low 2002). A factor that makes the diagnosis even more elusive is that postnasal space was often free of disease (Gouliamos et al, 1996). Low et al (2000) reported the following case report, which illustrated the typical features of CPA involvement by NPC.…”

“…Isolated lesions in the CPA that did not have tumor involvement of the skull base can involve the CPA, suggesting spread from the hematogenous route (Gouliamos et al 1996). Yuh et al (1993) suggested that metastatic cancers to the CPA could also arise from direct leptomeningeal spread or from dissemination through cerebrospinal fluid.…”